Kim, Youngdae

Kim, Youngdae is an individual health care provider with primary practice located at 5417D Backlick Rd , Springfield VA 22151-3915. He recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Dental Providers / General Practice. Dental Providers / General Practice is his primary health care specialty. Kim, Youngdae can be contacted via phone (703) 988-3386.

Contact Information

Primary practice address
5417D Backlick Rd Springfield VA 22151-3915
Fax: (703) 988-3389
Website:

Health care specialties

SpecialtyCodeLicense #State
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Dental Providers / General Practice 1223G0001X DS039841 Pennsylvania
Dental Providers / General Practice 1223G0001X 0401415145 Virginia

Profile Details

NPI number 1841612744
LBN Legal business name Kim, Youngdae
Credentials Doctor of Dental Medicine (DMD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 10th, 2014
Last updated Aug 1st, 2016 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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